Chapter Eight, Section ***I
Keith's success in re-assembling Biginali after her traumatic encounter with the bear, had its repercussions. His "surgical fame" had spread far and wide. So too had the teaching that one should not apply to wounds such concoctions as cow-dung, resins, mud, lime and the like. It now had become an established fact in the minds of many thinking villagers, that those who kept lacerations, burns and fractures clean, had a much better chance of recovery, especially if they protected them from flies and hurried to the mission. From time to time, however, we continued to treat some wounds that were more traumatized by secondary infection than by the initial injury.
The court cases, too, had their repercussions in relation to our medical work. Since the death of Jatibhai, following his beating by Krishnadeo, there were lurking fears and suspicion that the authorities might someday try to implicate us in a case of manslaughter or even murder. Already, there had been attempts to blame Keith for the death of Jatibhai. Rumours had spread, attempting to link James' case with Keith's, alleging that Keith had led a group of Christians across the provincial border into Surgapam to incite a riot, in the course of which, Jatibhai was said to have succumbed to injuries.
On another occasion, the police verbally charged Keith with running over a man in the Mission Jeep. Fortunately, detailed entries in his diary convinced the police that it would be impossible for them to establish a prima-facie case. Ever since the beginning of the persecutions, Keith had developed the daily habit of recording in his diary all events in his schedule that might need recalling for self-defence. These included exact times of departures and arrivals, places visited, routes taken, passengers carried and persons contacted, especially if they could be called on as court witnesses.
Even file reference numbers pertaining to business matters, were included in the entries. Such minute recording proved very helpful when Keith was accused by the local Daroga of a "crime" said to have been perpetrated on the very day he was undergoing a surgical operation at Mandanali, near Ranitola. The diary entry gave the reference in the "Inwards Account" file and, sure enough, there was the receipt for the bill paid to the Holy Family Hospital. This was shown to the Daroga who sheepishly withdrew his incriminations.
Really, I felt sorry for this weak-spined Sub-Inspector who, being a Muslim, was very much under the pressure of powerful Hindu extortionists of the area. Obviously he had been heavily bribed to have us removed by any means, cost what it may. Actually, it was on the Surgapam side of the border where our fears could be more substantiated. Janice Russell lived in constant fear of false charges being brought against her.
Particularly in relation to our medical work, we were kept under constant surveillance, like a cat watches a mouse.
There were times when, because of our fears, patients could not be prevented from dying. On a number of occasions, particularly during famine times, we were able to save some critically emaciated patients by administering nourishing fluids intravenously. But there were some unfortunate sufferers who were so dehydrated that a vein could not be found without making a small and simple incision. During such times when fear over-shadowed our work, to apply the scalpel, even to simply expose a vein, would mean running a grave risk. If, later, the patient should happen to die' due to other causes, it would not be those reasons to be considered as contributing to death, but the use of the scalpel!
For the same reason, because we were illegally administering allopathic antibiotics and other "Schedule H" drugs, making us vulnerable to those who wanted to concoct legal charges against us, Keith took a course in Homeopathic Medicine, which we found helpful in certain treatments, but very time-consuming. Besides, we had to order all our Homeopathy medicines from Calcutta, by post - a costly business.
It was because of the greater risks demanded of Janice, that one day we received a patient from her Surgapam clinic. A poor villager from the Kushmangal plateau area had been seriously mauled by a bear and was carried down the mountain on a bed to be treated by Janice. The man was lucky to be alive at all, for he had multiple deep lacerations to his head, face and shoulders. There was every possibility that the victim could die through loss of blood, or from shock. The risk was too much to take on the Surgapam side, so Janice thought it best to send the patient to us; besides, we had ether to help in the suturing.
Already he had been carried thirty jerking miles to Karanja, so the extra twenty miles to Bhavnagar didn't help matters. When he arrived at our clinic, we doubted if he would survive. His head looked as though it had passed through a mincing machine. The area around one eye was shockingly mangled, with flesh hanging in shreds. We were sure that the eye had been ruptured and that posed a real problem, for we had received no training in ophthalmic surgery!
The rotting mess that seemed to fill the eye socket worried Keith who was afraid to clean it out. We had heard that damage to one eye can often result in the other eye also being adversely affected. Keith had seen Dr. Rambler remove several eyes during the Eye Camp and, in fact, he had assisted in such operations. Also, each week, outside the hostel kitchen, it was a commonplace experience for us to see a goat part with its eyes. But for Keith, who was neither a doctor nor a butcher, the challenge proved to be too much.
A year earlier, Keith had been the Mission's delegate to a conference of the Disciples Mission, to which the European Baptists in Orissa had been asked to send representatives. The two missions had been working in close co-operation on the M.P. - Orissa border. During that week in Bilchandpur, Keith was fortunate to have a very talented surgeon for a roommate, Dr. Stanton Thompson, M.B.E. - who had a most distinguished ministry at the Moorland Memorial Baptist Hospital in Udaipur, Orissa. Keith had a hernia, which Stanton offered to repair and the kind doctor helped in many other ways, especially in clarifying some of the matters that didn't make sense in the surgery textbooks.
Keith was able to see many operations at Udaipur including his own, Hernia op., while under a spinal anaesthetic and with the help of mirrors surrounding the operating table lamp; not that he would ever attempt to perform a real operation! Suturing lacerated patients back together again was the limit of Keith's surgical expertise, although there were times when he had to yank out decayed bits and pieces of interphalangeal and metacarpal joints and use the scalpel to cut away gangrenous parts and trim up the badly ulcerated feet of leprosy patients. After returning home from Orissa, Keith and Stanton occasionally corresponded, and it was to this compassionate surgeon that Keith appealed for help.
"Help, help, Stan," Keith wrote in desperation, "how do you take out a mangled human eye? Please reply at your earliest convenience, giving me a few clues." Weeks passed before Stan's reply arrived in the post. Meanwhile, many of the lacerations had knitted nicely and the extensive swelling had subsided. The area around the right eye had been so badly injured that it was impossible to do any suturing. Stan's detailed instructions were very carefully studied and Keith was gradually gaining confidence to attempt his first "real" operation - the removal of a ruptured human eye!
I had been gazing into the awful mess, just wondering how we were going to tackle the problem, when I saw what appeared to be a black bead in a ball of mincemeat. "Could that be the eye?" I wondered. Well, there was one way to test. Placing my hand over the patient's good left eye, I held up two fingers and asked him to count. "Two," came the reply. I repeated this several times, using different numbers of fingers, to make sure there could be no doubt. Sure enough, the eye was sound and eventually our disfigured friend returned home healed and with his full sight.
Some time later, we received another bear-maul patient with injuries almost identical to those of the case just mentioned. The victim was about the same age, appeared to be just as primitive and was garbed only in the briefest loincloth. Because of his obvious illiterate condition, he was asked to give his approval for treatment by thumb impression, rather than signature.
To each patient whose treatment involved us in any measure of risk, a "Statement of Consent" was read out in Hindi and, if the patient, because of illiteracy, could not agree to our conditions by signing on the dotted line, his thumb- impression was required. A literate person also had to attest that the impression was really that of the patient. Once we were satisfied that we were legally "covered", the patient qualified for what "surgery" we could offer, also antibiotics, injections, dental extractions, various "Scheduled Drugs", intravenous administrations, "anaesthetics etc.
According to the Statement, the patient agreed that, because there were no other medical facilities in the area, he would submit to any treatment deemed necessary. He also agreed to take full responsibility if there was any subsequent worsening of his health.
We doubt whether all this procedure would have carried much weight in a court of law but, for our own protection, we had to convince the public that they wouldn't have a chance of succeeding in suing us for medical/surgical negligence.
As our latest patient met all the conditions, Keith prepared to take his thumb impression when his wife suddenly came forward and stood in front of her husband. "Indeed not," she interjected, "you'll never get my husband to give his thumb-impression. What an insult! My husband is literate. Why, he's even been to London and Paris!"
Patient who had been to London and Paris in World War I. He was mauled by a bear.
Imagine our surprise to hear such a statement in the middle of one of India's most remote and primitive jungle areas. The only way our patient had to endorse the seemingly extravagant assertion of his wife was to nod his head affirmatively. The inaudible words he tried to mouth, in spite of so much pain and infection, spilled out through the gaping holes in his cheeks and below his chin. But at least he could sign his name, which lent some credence to his wife's proud claims. As soon as he was able to communicate verbally, Keith lost no time in trying to ascertain whether or not our lacerated friend was the experienced world traveller his wife made him out to be.
"Tell me about London," questioned Keith with a raised eyebrow. "What do you remember most of all about that city?" We were utterly amazed to hear our friend give a fairly accurate description of Big Ben, Tower Bridge and The Houses of Parliament. It was obvious that he had not gained this information from a travel brochure.
All doubts were dispelled when our friend, through sutured lips, told of his visit to Paris where he saw a great iron tower (Eiffel) that was so high that it almost reached the heavens.
A crowd was gathering on the clinic verandah to hear the exploits of this old man of the world. Addressing his audience of patients waiting their turn for treatment, he said, "My wounds are nothing. I have seen men blown to pieces on the Fields of Flanders." Although he had suffered many severe lacerations to face, head, shoulders and upper arms, he said, "My injuries are mere scratches compared with what I saw in World War One." Yes, our educated friend had travelled abroad as a batman to a British Army Officer and his stories astounded us.
Another memorable bear-maul case was a young
twelve-year-old girl who had been out in the fields, called of nature to do her
daily toilet under a Mahua tree. The tree was in full fruit, dropping its
honey-rich blossoms, which are a bear's delight. While squatting, she was
attacked from the rear by a bear, which clawed her on the buttocks and bit her
shoulder.
Fortunately, she was able to escape, but the mauling
left her with frightful injuries. The mouths of bears are full of pollution,
which is driven deep into the wounds. Even though the patients received full
courses of broad-spectrum antibiotics, healing was often slow and painful. Her
deeply lacerated buttocks exposed much muscle and bled profusely. Fearing that
she would die through loss of blood, the village people, instead of applying a
pressure pad, decided to stuff the gaping wounds with lime! That certainly
stopped the bleeding, but it also caused almost unimaginable swelling of the tissue.
A huge mass of muscle, about the size of a large grapefruit, gradually erupted from the gash made by the bear's claws, which had penetrated right to the bone. It was horrible! Due to it being seed-planting time, the girl's parents could not afford to be away from the fields to tend their daughter in our "hospital". Because the girl did not like living alone as an in-patient, she chose to remain at home and walk the painful six-miles daily, to have her wounds dressed. She maintained this agonizing routine for six-weeks until, gradually, the swollen muscle receded and her other injuries healed.
Among the almost uncountable number of bear-maul cases for which our clinic was becoming a "specialized treatment centre", was a patient we called the "Tangiwala" or" Axe-Man." A tangi is a small Axe, weighing no more than half a kilogram, which can be used by aboriginal people with considerable dexterity. No tribal feels at home in his jungle haunts without this weapon to protect him from the wild animals. But it also has an economic purpose.
The Forest Department has strict rules about the felling of trees. No tree may be cut without a special permit and in those days, permits were difficult to get; today, virtually impossible. Timber was needed to roof the simple mud huts and bamboo was used to support the village-made roofing tiles. The doors and windows also were made of wood. Firewood was needed for warmth and cooking and some sort of fencing was a necessity to protect the precious crops from marauding beasts, both domestic and wild.
The Forest Rangers may not view it in this light, but the local people, as one means of survival, had a wonderful spirit of co-operation that met many of their village needs out of jungle produce. There were no government rules against the collection of dry, fallen timber. Each villager, therefore, while being careful to keep out of range of forest guards, kept his tangi in constant use, lopping off a limb here, a twig there and leaving them to dry! Whenever possible, a nice straight tree would be slashed or ring-barked and left to stand, eventually to be toppled in a storm. Occasionally, smaller trees would be completely felled. They might never serve the actual person who struck the deathblows but the latter would benefit from the cutting done by some other tribal person many months earlier.
With little success at all, the Forest Department often had given public lectures in the villages on the need to preserve the forests, although the "Greenhouse Effect", "Ozone Layer" and all that sort of terminology was unknown in those days. The Department also had tried to introduce legislation banning the carrying of tangis in the jungle but the Adivasi tribes' demands forced the government to concede because the tangi was essentially declared a weapon of self-defence.
And certainly it was for our latest bear-maul victim. He had been protecting his corn crop when a bear attacked, knocking him to the ground and savagely biting his leg. His thigh was so shockingly injured that one would imagine amputation to be the only solution to his problem. Thick strips of flesh hung in ribbons, posing one of our most difficult suturing jobs.
However, it was not his physical injuries that call this patient to mind but rather the mental trauma resulting from severe shock. From the moment of his attack until we were able to administer sedation, he talked constantly and fondled his tangi affectionately. "But I hit him, didn't I? I really hit the bear. Yes, I hit him on the head. I really hit him hard. I hit him with my tangi." And so on and on and on, hour after hour, the incessant babble seeming never to end.
If he once said he hit the bear, he must have said it hundreds and hundreds of times. Owing to the shock this patient had suffered, mental tension called for the use of Chlorpromazine, a tranquilliser which, along with other sedatives, had proved to be very helpful in such cases.
For several weeks, until he was completely healed, both physically and mentally, whenever the effect of the drugs wore off, he would again express desires to hit that bear and kill it, come what may. One chilly morning, just before dawn, when early mists produce a somewhat ethereal atmosphere in the damp jungle, I beheld a vision from my bedroom window. It seemed as though an apparition, shrouded in white from head to foot, was gliding slowly into the greying mist.
By the time I was able to check out on this ghostly experience, the Tangiwala had vanished into the mountains about four miles away. His pride had been hurt more than his hide and he was determined to take revenge. Because his wounds were far too extensive to be covered only with bandages, daily, I had provided him with a large white sterile bed-sheet to completely cover himself from head to toe, to protect also the many nicks and lacerations that covered most of his body. It was this sheet that gave our friend a phantom-like appearance.
He was away for several days, searching in vain for the bear, but returned in time to have his one hundred-plus sutures removed. His hunting expedition for that elusive bear probably had a therapeutic effect as good as, if not more beneficial than all our fancy tranquillisers. Even though he was not able to catch the bear, the fact that he made an effort to do so, resulted in his return to normal mental health.
Another bear injury that stands out in our memory, is that of a twelve-year-old boy. He was of a nomadic tribe, which travels constantly from one district to another, grazing cattle and goats and trading in them. Like the girl of the same age previously mentioned, the boy was mauled in the early hours of the morning while attending nature's call.
In this case, the injuries were inflicted on head and scalp. Like the girl, he also had been bitten on the shoulder but the bite marks were hardly visible. In spite of this, the pain in the shoulder lasted much longer than that of the more ghastly-looking wounds to the head. Being strangers to the area, the boy's parents had not heard of the necessity of keeping wounds clean so, in an attempt to stop the bleeding, they virtually encapsulated the head of their son in a helmet and mask made of a mixture of mud, ashes and cow dung!
This case posed a real problem, because we had exhausted our supply of ether and, without anaesthetic, it would be impossible even to clean the wounds, let alone suture the tattered flesh back into place. Keith had instructed our two para-medics, Suresh and Sarson, sufficiently enough to permit them to tackle the job themselves so, this time, it was Sarson who actually did the suturing and he did it beautifully.
Not being able to anaesthetize the boy meant that we had to drug him in the best way we could. In a layman's sort of way, we ended up giving him adult doses of "Largactil" and Sodium Phenobarbital injections, along with Codeine tablets. Although we had no previous experience in hypnosis, we thought we would give that a go too, just for good measure!
Speaking ever so softly and tenderly to the boy, we told him to, "go to sleep, go to sleep, go to sleep " and it worked.
We never were to know if our dabbling in hypnosis really contributed or if it was the concoction of drugs that did the trick. The main thing is that we "put him out to it!" Except for times when a major nerve was touched, the boy hardly blinked an eyelid during his surgical ordeal. Our patient's scalp had all but been ripped off and, like Biginali's, was attached only to one side of the head.
It seemed that the bear had either clawed or bitten away portion of the scalp, for when all the various parts were stretched and sutured into place, a portion of the skull remained exposed. However, it didn't seem to inconvenience the young boy to have a two-inch diameter piece of dry skull bone standing out white against his jet-black hair. In fact, he was very proud of his crowning glory, which appeared a lot like a small Jewish prayer cap!
Of all the most unusual cases we had to handle, I think that the one we shall ever remember was Patias ki Ma, meaning the "Mother of Patias". Uraon tribal tradition does not favour the use of a family or given name being used to address parents, whether mother or father. The former would be called, "the mother of the eldest child". The treatment of this patient was so unique that it is worth mentioning, but as Keith had most to do with her in the early stages, I'll let him tell the story.
. Chapter Eight, Section II
At the time of this incident, Ruth and I were living in Nawapara and had only just started our clinic work in Surgapam District with an acute shortage of much essential equipment and supplies. Also with only para-medical experience, we did not qualify for many facilities, which were made available to missions by voluntary organizations. Besides that, the funds allocated to the clinic in the Mission budget in those early days was a mere twenty-five rupees a month, or approximately two and a half dollars a month! That was to meet the needs of many thousands of people over several hundred square miles. How to overcome the problem?
Well, there were times when Ruth and I had to invest nearly three quarters of our salary in order to save lives, but our benevolence had its repercussions and later involved us in serious trouble with the British Mission Home Board. Fortunately, our lay practices in medicine, surgery and dentistry had a fruitful spin-off in that our fame spread to the town where Daulatapur doctors and drug-stores proprietors took pity on us being so isolated with no proper medical facilities in the area and so many sick and dying people dependent on us. In this way, I came to be respected by the medicos of the town and, when visiting their clinics to "pick the brains of the doctors and chemists", would be introduced to the travelling sales representatives of various Calcutta Pharmaceutical Companies as "Doctor" Skillicorn.
With my name now on their mailing lists, I found myself the recipient of considerable quantities of "sample" drugs, which met many of our needs covering "prescription" items. You may question the right or wrong of this but, for us in our desperate position, we had to apply "situational ethics"! Also, our technica1 knowledge in medicine was limited and we had to wait patiently for the training we dreamed of taking and finally did receive in three Indian hospitals after twenty years!
But back to "Patias ki Ma" and the account of what can be done with so few resources and a little medical knowledge when the problems that overwhelm us are committed to Christ, the Healer.
Patias ki Ma was an elderly lady who had fallen victim to malaria. Being of the cerebral type with prolonged high fever affecting the brain, the disease manifested itself in a most peculiar way. In the case of this dear old lady, what made her behaviour so memorable was the way she spat out all that went into her mouth. Profuse sweating during bouts of high fever results in rapid dehydration, so the patient must take in plenty of water. But over a period of four days, Patias ki Ma's fluid intake was so minimal that the family feared she would die of thirst.
Occasionally, she would condescend to let a whole glass of water pass her lips, but only to fill her mouth. She permitted nothing to pass down her throat. Just when the family expected the old lady to swallow the life-giving liquid, she would squirt it out, often hitting her target spot on!.
Real fears of death by dehydration prompted the family to prize open her mouth, breaking two upper front teeth in the attempt. With the mouth now partly open, a small metal funnel, used to fill a bottle with kerosene, was forced in, the tapered stem being wedged in the gap left by the knocked-out teeth.
With the instrument held firmly by the clenched jaws, the family was trying to force the funnel just a little further into the mouth, to be sure the water would go down the throat when, for some unknown reason, she decided to open her mouth, releasing the pressure. This allowed the sharp spout of the funnel to gouge an angry groove along the top of the tongue and roof of the mouth, ending its travel embedded in the back of her throat. The injuries sustained in this way proved, in the end, to be more serious than the malaria itself.
As was often the case, at the 'eleventh hour', when all hope had abated, it was decided to call in the Sahib. I received the urgent request at near midnight and presumed that the victim only had malaria. Taking with me chloroquin tablets, alkaline mixture and aspirin, I set off on my cycle for an hour's precarious trip through the dark jungle, along the narrowest of paths. The scene that confronted me, on arrival at the home of the patient, was one of utter panic and confusion.
I had not been informed that Patias ki Ma could not be given oral treatment, otherwise I would have gone equipped to give a quinine injection. It seemed that the only thing to do was crush the tablets in water and administer the mixture from a spoon. With the help of a thick, tapered stick, I wedged her teeth apart and poured in the first dose which I tried to wash down with water. While examining the inside of the mouth as best I could to see what was causing the obstruction, I was squirted in the eye with the full contents of her mouth.
It was only then that I was told, "Oh, she's been doing that for the last five days!" There was nothing else to do but order the family to take the old lady to the clinic for day injections of quinine. It was dawn, later that morning, when she arrived with her husband and two other family members who had carted her on a bed. There were all the symptoms of malaria but there seemed to be other things the matter, which the family did not wish to divulge, such as the accident involving the funnel. Finally, after much questioning, the whole story came out.
By this time, serious infection had set in, resulting in a tongue so swollen that it almost filled her mouth. The infection extended back into the throat, not only compounding the problem of eating and drinking, but also critically affecting her ability even to breathe through her mouth. In later times, when equipment became available, we were able to provide nourishment to such patients intravenously, but in those early pioneering days we were equipped with neither IV kits nor tubing for forced feeding through the nasal passages. We also had no autoclave equipment to produce distilled water or normal saline.
The old lady's throat was now a mass of swelling and infection, so it was essential that her nasal airways be kept clear to make breathing possible. While people may be able to remain alive without food for anything up to two months, regular and plentiful intake of fluid is essential for survival, but how to get the fluid into her system? That was the vital question.
There were several dozen boxes of 5 & 10 ml phials of Normal Saline used for making up injections of antibiotics and this we gave intramuscularly in 10 ml shots in every muscle that was available. Along with the quinine injections we were giving for the malaria and the penicillin administered for her mouth and throat infection, the poor old soul had virtually become a pincushion. What else could we do with our limited knowledge, experience and resources?
I knew that this could not go on for much longer. Our supply of ampoules would soon run out and we would have no way of replenishing our stocks with the road closed due to heavy rain which had also brought up the rivers in flood. Much prayer went into the treatment of this dear old lady as Ruth was busy poring over the medical books for some clue on rehydrating such a dried- out patient. Finally, she found the secret -- the old-fashioned enema for which we had all the necessary gear.
We discovered that about one third of the retained fluid is absorbed into the blood stream through the bowel. We first gave her the regular soapy-water treatment, but the second course was somewhat more savoury being a rectal cocktail of Vegemite, Horlick's and Glucose! This, along with her medication, brought about a marked improvement in her condition.
Within two days, we had become sure that she would survive. However, even though the fever had subsided and the infection of mouth, tongue and throat brought under control, Patias ki Ma still refused to open her mouth voluntarily, possibly indicating that the prolonged fever of malaria had resulted in some adverse brain involvement. Her husband, however, offered a different rationale for her weird behaviour. "Sahib," he said, "this is the work of the devil. Let me handle her!"
By this time, her husband, "Patias ka Bap" (father of Patias), was developing some reservations in his mind about my ability to heal his wife, in spite of me having become a "famous physician & surgeon" in the area!
He concluded that if the Sahib can't save her, then she must be under the spell of the "Principalities & Powers" - the "bhoots" - for which reason our modus operandi needed a more spiritual content!.
The old lady was lying on a grass mat that covered the mud floor of the clinic. Patias ka Bap kneeled beside his wife and lifted up her head by the hair, looking straight into her eyes. He was mumbling something in his village dialect but seemed not to be addressing his spouse. Instead, he was talking to "Shaitan" (Satan) and, using the most vitriolic language, took on the role of an exorcist. What he said would best be translated into English or, more appropriately, plain Aussie "lingo" as, "Get to the bloody hell out of here you %$#@ */+(*# and leave her alone. In the name of Jesus Christ, get moving'!".
Still holding up her head by the hair, and continuing to address the devil, he slapped his wife's face so violently that I felt I should intervene. I was just about to stop this shocking display of male chauvinism, when the old man adjusted his kneeling position as though to embrace his wife. Then, in what seemed to be an affectionate apology for the ignominious treatment he had meted out, he took her head in both hands and, for a while, gazed into her eyes as though pleading with her to open her mouth to take her nourishment in a more traditional and dignified manner. And then - CRASH - ; down went her head, being pounded into the floor by the husband.
He must have repeated this at least six times until, fearing that my patient might suffer concussion, I had to call a halt to this rather unconventional therapy. Reaching for a glass of water with his right hand, while still holding his wife's head by his left hand, he looked directly into her eyes and ordered, "Ab peeow - now drink!" To the utter amazement of all of us in the room, the old lady opened her mouth8loluntarily, for the first time in well over a week and drank a full glass of water, down to the very last drop.
Racing over to the bungalow, I said to Ruth, "Quickly, make up a glass of skim-milk and Horlick's." Within a few minutes, that, too, went down and the next day she was on her feet and able to walk a hundred yards to the bungalow to visit Ruth. She could remember absolutely nothing of her experiences during that eventful week.
The old man was jubilant; maybe his violent treatment helped to sort out a few of his wife's brain neurons but, so far as he was concerned, it was the departure of the "bhoots" that had done the trick!
We continued successfully to treat many people for malaria, after learning how to test the blood for detection of parasites in the red cells. The Government of India established a special department, under the Ministry of Health, to check this killer disease in the hope of eventually eradicating it. We were encouraged to note, over the years, a gradual reduction in the incidence of malaria, even in highly endemic areas such as Bhavnagar. Thousands of persons were recruited to spray DDT in every inhabited building throughout the whole country and it is quite possible that, had there been honest support of this systematic campaign on the part of every member of the community, the eradication program might have met with success.
But there were those who objected to their homes being sprayed. Some did not like the white residue left on the furniture. Others, who had food grains illegally stored in their homes, were loath to open their doors to sprayers who could reveal vital, incriminating evidence to the police. In my own experience, I know of sprayers who would accept a bribe of money, food grains or maybe a chicken, to pass by a house, which would still be marked as though it had been treated with DDT.
And so it is that malaria is again on the rampage, with the offending Anopheles mosquito developing resistance to a variety of insecticides, and the actual parasite gaining strength over a number of once- potent anti malarial drugs. At the time of writing, the situation poses a severe threat, not only to the people of India, but also those of neighbouring Bangladesh, Indonesia and other countries, particularly Africa frightening!